crossing96/oncoscreening huggingface dataset:
[Transurethral resection in saline (TURis): a newly developed TUR system preventing obturator nerve reflex].	PURPOSE: We developed an innovative transurethral resection system (TURis) consisting of a uniquely-designed generator and a resectoscope. The obturator nerve is protected from troublesome reflexes during TURis because the high frequency current delivery route is via the resection loop to the sheath of the resectscope and not via a patient plate. After extensive preclinical evaluation and verification of the system using an animal model to ensure efficacy as well as operational safety, TURis was conducted for treatment of superficial bladder cancer and benign prostatic hyperplasia. MATERIALS AND METHODS: In preclinical experiments swine bladder wall was transurethrally resected using the system in a saline environment. The results were compared with data obtained from an identical resection using the conventional system using sorbitol solution irrigation. Electrolytic contents were measured after TUR for comparative evaluation vis-a-vis corresponding pre-TUR data. Also, the depth of heat degeneration was measured in the resected tissue. From December, 2000 to June, 2002, TURis was performed in 25 cases of superficial bladder cancer and 30 cases of benign prostatic hyperplasia (BPH), using saline irrigation. All 55 cases were performed under spinal anesthesia without an obturator nerve block. The output power was set at 280 W for cut and 120 W for coagulation. A smaller electrode than those used in conventional TUR was used to improve the cutting efficacy. Occurrence of obturator nerve reflexes, difference of hematocrit and electrolytic contents before and after TURis, operation time and total volume of irrigated saline were evaluated. RESULTS: TURis in animal model: No adductor contraction of a lower limb was observable except for minimal creeping during the resection of a site close to the urethra. There were no apparent anomalies relative to the blood electrolyte content after TURis. No difference was observed in the mean depth of heat-degeneration tissue change compared with the conventional system. TURis for bladder cancer and BPH: No additional skills were required for TURis compared to conventional TUR. No obturator nerve reflex was observed except for a clinically insignificant thigh movement in one case of bladder cancer. The post-TURis blood tests manifested no significant anomalies in blood electrolyte content. Mean operation time for bladder cancer and BPH were 32 and 42 minutes respectively. Mean volumes of saline consumed during TURis were 6,083 ml for bladder cancer and 16,100 ml for BPH. CONCLUSIONS: TURis worked effectively in a saline-irrigated environment. It does not need a patient plate and obturator nerve block even in cases of bladder cancer on the lateral wall. In addition, saline was both safe and cost-effective compared to non-electrolytic solution as irrigant for TUR of BPH. This suggests that TURis may have more applications than conventional TUR.	bladder
Diagnostic value of urinary molecular markers in bladder cancer.	OBJECTIVES: In an attempt to find a more sensitive and specific non-invasive diagnostic assay for the detection of bladder cancer cells, the authors assayed the exfoliated cells from patient's voided urine and bladder washing fluids for the presence of telomerase, an enzyme that maintains a cell's chromosomal length, metalloproteinase-9 (MMP-9), which has been associated with tumor cell invasion and metastasis. Their results were compared with both voided urine cytology (VUC) and bladder wash cytology (BWC) for the detection of bladder cancer cells. MATERIALS AND METHODS: The authors used preoperative voided morning urine samples from 110 subjects for telomerase, matrix metalloproteinase-9 (MMP-9) and cytology. Bladder wash samples were obtained for telomerase and cytology. Of 110 cases 73 were histologically diagnosed as bladder cancer, whereas the remaining 16 had benign urological disorders. A group of 21 healthy volunteers were also enrolled in this study. Cystoscopy was done for all patients as the reference standard for the identification of bladder cancer. Biopsy of any suspicious lesion was performed for histopathological examination. RESULTS: Receiver-operator characteristics (ROC) curves were used to determine the optimal threshold values for telomerase activity in urine, bladder wash and MMP-9 [0.05, 0.088 and 0.51 (ng/ml), respectively]. The levels and the positivity rates of telomerase activity and MMP-9 were significantly higher in the malignant group compared to either the benign group or normal controls. Bladder cancer patients with positive cytology revealed positive telomerase activity in urine, bladder wash, and MMP-9 in 92%, 87% and 61%, respectively. Also, these positive rates were significantly higher in bilharzial bladder cancer cases (88%, 89%, 69%, respectively) compared to non-bilharzial cases (50%, 62.5%, 50%). The overall sensitivity and specificity were 83% and 88.6%, 86.3% and 78.3% for telomerase activity in urine, and in bladder wash, respectively. 66.6% and 80% for MMP-9, 58.5% and 100% for voided urine cytology and 64.4% and 100% for bladder wash cytology. Combined sensitivity of VUC with the 2 biomarkers together was higher than either combined sensitivity of VUC with one of the biomarkers or than that of the biomarker alone. CONCLUSION: Urinary telomerase and MMP-9 had superior sensitivities over VUC; moreover, combined use of these markers increased the sensitivity of cytology from 58.46% to 95%. The higher sensitivities of markers in bilharzial bladder cancer than non-bilharzial type highlight their clinical utility in screening patients with urinary bilharziasis.	bladder
Over expression of CD44V8-10 in human bladder cancer cells decreases their interaction with hyaluronic acid and potentiates their malignant progression.	PURPOSE: We evaluated the effects of the over expression of CD44v8-10, one of the high molecular form of CD44, on the malignant potential of UM-UC-3 human bladder cancer cells in vitro and in vivo. MATERIALS AND METHODS: We introduced CD44v8-10 complementary DNA into UM-UC-3 cells, which do not express detectable level of CD44v8-10 protein, and generated the CD44v8-10 over expressing cell line UM-UC-3/v8-10 and the vector only transfected cell line UM-UC-3/C. The effects of the introduction of CD44v8-10 into UM-UC-3 cells on the ability to bind hyaluronic acid (HA) were analyzed by the cell adhesion assay and the cell migration assay. We then evaluated tumor progression of UM-UC-3 sublines after subcutaneous and orthotopic injection into athymic nude mice. RESULTS: There were no significant differences in in vitro growth rates. UM-UC-3/v8-10 cells showed significantly decreased binding and migration ability to HA but not to other extracellular matrix proteins. Furthermore, UM-UC-3/v8-10 cells demonstrated significantly increased tumor growth after subcutaneous as well as orthotopic injection into athymic nude mice and enhanced lymph node metastasis after orthotopic injection compared with UM-UC-3/C cells. CONCLUSIONS: These findings suggest that CD44v8-10 over expression in human bladder cancer cells decreases their interaction with HA and potentiates their malignant progression.	bladder
Extended radical lymphadenectomy in patients with urothelial bladder cancer: results of a prospective multicenter study.	PURPOSE: Previous studies demonstrate a positive correlation between postoperative survival and the extent of pelvic lymphadenectomies in patients with bladder cancer. However, the distribution of nodal metastases has not been examined in sufficient detail. Therefore, we conducted a comprehensive prospective analysis of lymph node metastases to obtain precise knowledge about the pattern of lymphatic tumor spread. MATERIALS AND METHODS: Between 1999 and 2002 we performed 290 radical cystectomies and extended lymphadenectomies. Cranial border of the lymphadenectomy was the level of the inferior mesenteric artery, lateral border was the genitofemoral nerve and caudal border was the pelvic floor. We made every effort to excise and examine microscopically all lymph nodes from 12 well-defined anatomical locations. RESULTS: Mean total number and standard deviation of lymph nodes removed was 43.1 +/- 16.1. Nodal metastases were present in 27.9% of patients. The percentage of metastases at different sites ranged from 14.1% (right obturator nodes) to 2.9% (right paracaval nodes above the aortic bifurcation). By studying cases of unilateral primary tumors or with only 1 metastasis we observed a preferred pattern of metastatic spread. However, there were many exceptions to the rule and we did not identify a well-defined sentinel lymph node. CONCLUSIONS: We strongly recommend extended radical lymphadenectomy to all patients undergoing radical cystectomy for bladder cancer to remove all metastatic tumor deposits completely. The operation can be conducted in routine clinical practice and our data may serve as a guideline for future standardization and quality control of the procedure.	bladder
Contemporary management of superficial bladder cancer in the United States: a pattern of care analysis.	OBJECTIVES: To assess the practice preferences among urologists treating superficial bladder cancer in the United States. METHODS: We surveyed 226 urologists using a specially designed survey instrument. The type of practice, number of urologists in group practice, annual volume of patients with bladder cancer, and those treated with intravesical therapy were assessed. We also obtained information on the American Urological Association section and year of graduation from urology residency training. RESULTS: Of the 226 contacted urologists, 105 (46%) returned a completed survey instrument. Seventeen percent were practicing in academic institutions and 63% were in independent community practice. Forty-five percent had graduated from urology training in or before 1985. Thirty-six percent were in small and 37% were in moderate-size groups. Thirty-five percent were treating a moderate number of patients with bladder cancer, and 44% were treating a large number of patients annually. Thirty-two percent had a moderate number and 40% had a large number of patients receiving intravesical therapy annually. Immunotherapy was preferred in patients at high risk of recurrence. Intravesical chemotherapy was preferred by many for immunotherapy failure. The type of practice and year of graduation were the factors most frequently affecting treatment choice. CONCLUSIONS: Practice preferences for the management of superficial bladder cancer are in general agreement with the American Urological Association Bladder Cancer Guidelines Panel recommendations. However, 81% of surveyed urologists were still reluctant to refer patients with high-grade Ta-T1 disease with failure after intravesical immunotherapy twice for more aggressive therapy such as cystectomy or radiotherapy.	bladder
Usefulness of urinary NMP22 to detect tumor recurrence of superficial bladder cancer after transurethral resection.	BACKGROUND: In a prospective study we compared the usefulness of urinary nuclear matrix protein 22 (NMP22) with that of urine cytology and other urinary markers in the monitoring of superficial bladder cancer after transurethral resection (TURBT). METHODS: The subjects were 156 patients, comprising 99 patients with superficial bladder cancer in whom TURBT was planned (untreated group) and 57 patients without tumors in the bladder who had been followed up after TURBT (follow-up group). RESULTS: Among the 156 patients, who were monitored for 11-26 months (median, 21 months), recurrence was observed in 51 patients (33.0%). At the time of recurrence, the sensitivities of NMP22, basic fetoprotein (BFP), and bladder tumor antigen (BTA) tests, and urine cytology were 18.6%, 23.3%, 9.3%, and 7.0%, respectively. The factors affecting the sensitivity of NMP22 were tumor size and urinary WBC. The size of recurrent tumors was significantly smaller (P<0.05) than that of the initial tumors. Based on receiver operating characteristic (ROC) curves calculated from the data of patients with recurrence, the ideal cutoff values at recurrence were recommended to be 5.0 U/ml for NMP22 and 6.0 ng/ml for BFP. Using these cutoff values, the sensitivities of NMP22 and BFP were 48.8% and 44.2%, respectively. CONCLUSIONS: Because the size of recurrent bladder tumors is usually smaller than that of the initial tumors, the cutoff values of urinary markers should be reduced to detect these tumors. We recommend 5.0 U/ml as a cutoff value of NMP22 for detection of recurrence of bladder tumor.	bladder
[Standardization and its importance in rendering medical care to patients with cancer of the bladder].	There are only as many as 31 specialized oncourological departments in 24 of 89 (27%) Federation Subjects in the Russian Federation that can render the oncourological care at the municipal and federal levels. As for other remaining 65 (73%) Subjects, the urologists are preoccupied with diagnosis and treatment of urinary-bladder cancer in them. Russian patient-care facilities have presently differing opportunities in the sphere of diagnosis and treatment of the mentioned pathology. Their related outfit for this purpose is on the whole unsatisfactory. An optimal management of medical care rendered to the discussed category of patients and targeted at promoting its quality and efficiency is possible only on the basis of standardization of diagnostic and treatment approaches. The stage-nature of medical care rendered to such patients is closely related the standardization issues. An accurate definition of stages and of patient-care facilities, which would be in charge for the above stages, would, in the end, clearly depict a sequence of steps for the diagnostic-and-therapeutic schemes applicable to patients with cancer of the urinary bladder. This, in its turn, would optimize the diagnostic-and-therapeutic process and outline the priority spheres in healthcare financing.	bladder
Stage pT1 bladder carcinoma: diagnostic criteria, pitfalls and prognostic significance.	Recognition of early invasion (stage pT1) in urothelial neoplasia is one of the most challenging areas in bladder pathology, and reproducibility between pathologists is a major issue. This fact, together with the proposal by some urologists to treat early invasive tumours more aggressively, makes the accurate detection of pT1 lesions even more relevant in clinical practice. In recent years, the morphologic features and patterns of invasion of tumour into the lamina propria have been more accurately characterised and standardised, and although some of the features are subtle, they can be of great utility in the accurate assessment of pT1 staging. Histologic grade, changes at the stroma-epithelial interface, the characteristics of the invading epithelium, and the stroma-associated response are among the most important clues for appropriate pT1 staging and these are discussed in this review. Common problems in stage pT1 disease evaluation include, tangential sectioning--due to an inability to orient transurethral resection specimens--crush and cautery artefacts, and a streaking inflammatory infiltrate. With few exceptions, the criteria discussed in this review allow pathologists to separate superficial bladder tumours consistently and reproducibly into non-invasive (pTa) tumours and tumours that have invaded the lamina propria (pT1), the latter having a significantly poorer prognosis. This review is intended to assist the surgical pathologist by presenting appropriate diagnostic criteria, by describing common pitfalls and by outlining the different histologic patterns of invasion of urothelial carcinoma into the lamina propria. The value of pT1 tumour substaging, as a predictor of bladder cancer progression is also discussed.	bladder
Intravesical bacillus Calmette-Guèrin for the treatment of superficial bladder cancer in renal transplant patients.	BACKGROUND: Intravesical instillations with bacillus Calmette-Guérin (BCG) is considered the treatment of choice in the prophylaxis of high-grade superficial bladder carcinoma and in the treatment of carcinoma in situ (CIS) of the bladder. METHODS: There is no previous experience with BCG treatment in patients with renal transplantation. Theoretically, immunosuppression is a contraindication because of the risk of severe morbidity and sepsis. We present our experience with endovesical BCG in three renal transplant patients, under immunosuppressive treatment, with high-grade superficial bladder cancer and CIS. RESULTS: Two patients are free of disease at 17 and 60 months. One patient developed disease recurrence and underwent a radical cystectomy. There was neither change in renal function nor any clinical evidence of tuberculous infection. CONCLUSIONS: Intravesical BCG in superficial bladder cancer and/or CIS is a valid option, with no added morbidity to renal transplant patients.	bladder
[Reiter syndrome after intravesical Bacillus Calmette-Guerin (BCG) immunotherapy: a case report].	A 56-year-old man who had previously undergone transurethral resection and intra-arterial chemotherapy for bladder cancer developed irritable bladder, bilateral conjunctivitis and arthritis including the knees, ankles and sacroiliac joints after starting intravesical Calmette-Guerin bacillus (BCG) immunotherapy. These symptoms were in agreement with the features of Reiter syndrome. One month after cessation of the intravesical BCG immunotherapy and initiation of the treatment with a non-steroidal anti-inflammatory drug (NSAID), he was not complaining of symptoms. Reiter syndrome is an uncommon complication after intravesical BCG immunotherapy. Nevertheless, since the prolonged arthritis has a possibility to cause joint deformity, we must pay serious attention to this side effect.	bladder
Radiosensitizer effect of wortmannin in radioresistant bladder tumoral cell lines.	This work analyzes the effectiveness of wortmannin in boosting the lethality induced by different doses of X-rays, using the colorimetric assay of MTT. Bladder tumoral cell lines differing in radiosensitivity and p53 status were used. Since wortmannin is able to inhibit DNA-dependent protein kinase (DNA-PK) and rejoining of double-strand breaks (DSBs), we have analyzed the constitutive contents and expression after irradiation of the catalytic subunit of DNA-PK (DNA-PKcs) in our cell lines with the aim of explaining the differential effect of wortmannin as radiosensitizer. Considering that DNA-PK is the main protein complex involved in DNA DSB repair, the ability to remove DSBs after irradiation (with or without wortmannin) was evaluated in the different cell lines by the use of pulse-field gel electrophoresis. Our results indicate a higher radiosensitization in the radio-resistant cell line that shows both high constitutive contents of DNA-PKcs and a high rate of DNA repair by the fast component. In contrast, no radiosensitizer effect of wortmannin was observed in the radiosensitive cell line, previously characterized as defective in DSB repair by a low repair fidelity, and - as our results show - with low constitutive contents and later post-irradiation expression of DNA-PKcs. No clear effect related to p53 status of the cell line was observed. These results suggest that high constitutive contents of DNA-PKcs are indicative of radio-resistant phenotypes, and analysis of the expression of this protein could be helpful in the optimal establishment of wortmannin as radiosensitizer in bladder tumoral cell lines.	bladder
Case-control study of bladder cancer and drinking water arsenic in the western United States.	Numerous epidemiologic investigations have identified links between high concentrations of arsenic in drinking water and cancer, although the risks at lower exposures are largely unknown. This paper presents the results of a case-control study of arsenic ingestion and bladder cancer in seven counties in the western United States. These counties contain the largest populations historically exposed to drinking water arsenic at concentrations near 100 microg/liter. All incident cases diagnosed from 1994 to 2000 were recruited. Individual data on water sources, water consumption patterns, smoking, and other factors were collected for 181 cases and 328 controls. Overall, no increased risks were identified for arsenic intakes greater than 80 microg/day (odds ratio=0.94, 95% confidence interval: 0.56, 1.57; linear trend, p=0.48). These risks are below predictions based on high dose studies from Taiwan. When the analysis was focused on exposures 40 or more years ago, an odds ratio of 3.67 (95% confidence interval: 1.43, 9.42; linear trend, p<0.01) was identified for intakes greater than 80 microg/day (median intake, 177 microg/day) in smokers. These data provide some evidence that smokers who ingest arsenic at concentrations near 200 microg/day may be at increased risk of bladder cancer.	bladder
Polymorphisms of the DNA repair genes XRCC1, XRCC3, XPD, interaction with environmental exposures, and bladder cancer risk in a case-control study in northern Italy.	Tobacco smoking and occupational exposures are the main known risk factors for bladder cancer, causing direct and indirect damage to DNA. Repair of DNA damage is under genetic control, and DNA repair genes may play a key role in maintaining genome integrity and preventing cancer development. Polymorphisms in DNA repair genes resulting in variation of DNA repair efficiency may therefore be associated with bladder cancer risk. A hospital-based case-control study was conducted in Brescia, Italy, to assess the relationship between polymorphisms in DNA repair genes XRCC1 (Arg(399)Gln), XRCC3 (Thr(241)Met), and XPD (Lys(751)Gln) and bladder cancer risk. A total of 201 male incident bladder cancer cases and 214 male controls with urological nonneoplastic diseases were recruited and frequency-matched on age, period, and hospital of recruitment. Detailed information was collected using a semistructured questionnaire on demographic, dietary, environmental, and occupational factors. Genotypes were determined by PCR-RFLP analysis. The XRCC3 codon 241 variant genotype exhibited a protective effect against bladder cancer [odds ratio (OR), 0.63; 95% confidence interval (CI), 0.42-0.93], which was prominent among heavy smokers (OR, 0.49; 95% CI, 0.28-0.88) but not among never and light smokers. No overall impact of the XRCC1 codon 399 polymorphism was found (OR, 0.86; 95% CI, 0.59-1.28), but a protective influence of the homozygous variant was suggested among heavy smokers (OR, 0.38; 95% CI, 0.14-1.02). XPD polymorphisms did not show an association with bladder cancer (OR, 0.92; 95% CI, 0.62-1.37). There was no statistical evidence of an interaction between these three genetic polymorphisms and either tobacco smoking or occupational exposure to polycyclic aromatic hydrocarbons and aromatic amines. The XRCC3 codon 241 polymorphism had an overall protective effect against bladder cancer that was most apparent among heavy smokers. Similarly, the XRCC1 codon 399 polymorphism also had a protective effect on bladder cancer among heavy smokers. The XPD polymorphism was not, however, associated with bladder cancer risk.	bladder